ROX-HR指数联合血浆BNP水平对脓毒症休克液体复苏效果的预测价值  

Predictive Value of ROX-HR Index Combined with Plasma BNP Level in Fluid Resuscitation of Septic Shock

作　　者：吴飞 时素琴 王玉荣 WU Fei;SHI Suqin;WANG Yurong(Department of Emergency Intensive Care Unit,Yangzhou University Affiliated Hospital,Yangzhou,Jiangsu 225000,China)

机构地区：[1]扬州大学附属医院急诊重症监护室,江苏扬州225000

出　　处：《转化医学杂志》2024年第5期705-709,共5页Translational Medicine Journal

基　　金：扬州市-扬州大学市校合作共建创新平台,扬州市大数据分析与知识服务重点实验室开发课题(YBK202208)。

摘　　要：目的探讨呼吸频率–氧合–心率(ROX-HR)指数联合血浆脑钠肽(BNP)水平对脓毒症休克液体复苏效果的预测价值。方法选取2023年1月至2024年1月扬州大学附属医院院收治的135例脓毒症休克患者作为研究对象,所有患者均接受液体复苏治疗,治疗前检测ROX-HR指数、血浆BNP水平,根据疗效分为失败组(53例)和成功组(82例)。多因素Logistic回归分析影响脓毒症休克患者液体复苏治疗效果的因素。受试者工作特征(ROC)曲线分析ROX-HR指数、BNP预测脓毒症休克患者液体复苏治疗效果的价值。结果失败组ROX-HR指数低于成功组(P<0.05),血清BNP水平高于成功组,差异有统计学意义(P<0.05)。高BNP、高SOFA评分、高血乳酸是脓毒症休克患者液体复苏治疗失败的危险因素(P<0.05),高ROX-HR指数是保护因素,差异有统计学意义(P<0.05)。ROX-HR指数、BNP预测脓毒症休克患者液体复苏治疗失败的曲线下面积(AUC)为0.794、0.759,联合预测曲线下面积为0.970,联合预测高于单独预测(P<0.05)。结论脓毒症休克患者ROX-HR指数降低,血浆BNP水平增高与液体复苏失败有关,联合ROX-HR指数和BNP可有效预测液体复苏效果。Objective To investigate the predictive value of ROX-HR index combined with plasma brain natriuretic peptide(BNP)level in fluid resuscitation of septic shock.Methods A total of 135 patients with septic shock admitted to Yangzhou University Affiliated Hospital from January 2023 to January 2024 were selected.All patients received fluid resuscitation therapy.ROX-HR index and plasma BNP levels were detected before treatment,and the patients were divided into failure group(53 cases)and success group(82 cases)according to the efficacy.Multivariate Logistic regression analysis was performed to identify the factors affecting the efficacy of fluid resuscitation in septic shock patients.The value of receiver operating characteristic(ROC)curve analysis of ROX-HR index and BNP in predicting the efficacy of fluid resuscitation therapy was evaluated.Results The ROX-HR index in the failure group was lower than that in the success group(P<0.05),while the serum BNP level was higher than that in the success group(P<0.05).High BNP levels,high SOFA scores,and elevated blood lactate were identified as risk factors for fluid resuscitation failure in septic shock patients(P<0.05),whereas an elevated ROX-HR index was identified as a protective factor(P<0.05).The area under the curve(AUC)for predicting fluid resuscitation failure was 0.794 for the ROX-HR index and 0.759 for BNP.The combined prediction model showed an AUC of 0.970,which was significantly higher than the AUCs of individual predictors(P<0.05).Conclusion Decreased ROX-HR index and elevated plasma BNP levels were associated with fluid resuscitation failure in septic shock patients.The combination of ROX-HR index and BNP levels effectively predict the efficacy of fluid resuscitation therapy.

关 键 词：脓毒症休克 液体复苏 呼吸频率–氧合–心率 脑钠肽 

分 类 号：R631.4[医药卫生—外科学]